Increased PSA after prostatectomy may not result in metastasis in some men’s lifetime

the Oncology Nurse Advisor take:

According to a new study published in the journal Clinical Cancer Research, researchers at Fred Hutchinson Cancer Research Center in Seattle, Washington, have found that some patients with prostate cancer whose prostate-specific antigen (PSA) levels become elevated after a radical prostatectomy may die as a result of a cause unrelated to prostate cancer before being diagnosed with cancer metastasis.

Therefore, active surveillance may be more beneficial than treating them for recurrence. For the study, the researchers analyzed data from various studies including patients with prostate cancer. Using this data, they created a simulation model to determine the number of patients with PSA recurrence who would die from unrelated causes in less time than it would take for PSA recurrence to cause metastasis in the absence of treatment.

They found that 9.1% and 15.6% of patients with prostate cancer whose PSA levels are elevated 5 years and 10 years after their initial treatment, respectively, may not experience metastatic disease before dying. Those patients are therefore overdetected for recurrence as the likelihood of recurrence before death is low. The simulation also found that 31.4% of men older than 70 with PSA recurrence within 10 years of initial diagnosis were overdetected.